Spine Thoracic Spine Lateral

Indications for imaging Congenital abnormalities, scoliosis, trauma, pain, metastasis's. Anatomy  Demonstrated Thoracic vertebra, Thoracic Spine Lateral Anatomy Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies on one side on the table, mid-sagittal plane parallel to the table top and mid coronal plane midline aligned to the midline of the table, the hips and knees flexed 45 degrees to support the patient and minimise movement, raising the arms well above the head maximises visualisation of the upper vertebrae. Thoracic Spine Lateral Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Radiation protection There are many local rules for gonad protection however the following should be taken into account. The 28 day rule should be applied for female patients. In males and females direct lead rubber gonad protection can be applied at all times,  Central Ray The vertical central ray is centered at the level of T7, at the level of the tip of the sixth spinous process when counting down from the prominent spinous process of C7 at the midpoint of the thoracic curve, i.e. midway between the most posterior dorsal skin surface and the anterior border of T1. Exposure is made on suspended inspiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 85 20 100 Yes Fine Yes 30 x 40 cm Evaluation of the Image ID and markers must be present and correct in the appropriate area of the film Evidence of collimation on four sides equally around the centering point. Optimal exposure should penetrate all the bone structures and contrast should be low enough to visualise fully the bone and soft tissue structures. Limits of the examination, superiorly the upper border of C7, inferiorly the lower border of L1, laterally the medial part of the posterior ribs. The intervertebral joint spaces should be visible, the spinous processes should be projected over the centers of the vertebral bodies. Thoracic Spine Lateral Radiograph Related Projections Thoracic spine Later Cervical spine AP Lumbar spine AP Additional modalities CT MRI

Spine Lumbar Spine Lateral

Indications for imaging Congenital abnormalities, trauma, pain, metastasis's. Anatomy  Demonstrated Lumbar vertebra. Lumbar Spine Rt Lateral Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Basic Patient Position The patient lies on the table with their long axis in line with the long axis of the table, a line at a tangent to the third lumbar vertebra should be in line with the midline of the table. The hips and knees are flexed for stability and the hands are placed on a pillow in front of the patients face. Ensure the line of the spinous processes are parallel to the table if not use pads to adjust the position. Lumbar Spine Lt Lateral Patient Position Meschan, I. 1955 An Atlas of Normal Radiographic Anatomy Saunders, London Radiation protection There are many local rules for gonad protection however the following should be taken into account. The 28 day rule should be applied for female patients. In males direct lead rubber gonad protection can be applied at all times, in females positioning rules will determine protection in females. BMJ Article about dose reduction in Lumbar spine lateral imaging Ref: Northwest Medical Physics. NEWSLETTER NO 41 – MAY 2006 DIAGNOSTIC X-RAY AND NUCLEAR MEDICINE Central Ray The vertical central ray is centered in line with the highest point of the iliac crest at a point midway between the lower costal margin and the iliac crest of the raised side. Exposure is made on suspended expiration. Exposure Factors Kv mAS FFD (cm) Grid Focus AEC Cassette 90 90 100 Yes Broad Yes 30 x 40 cm Evaluation of the Image ID and markers must be present and correct in the appropriate area of the film Evidence of collimation on four sides equally around the centering point. Optimal exposure should penetrate all the bone structures and contrast should be low enough to visualise fully the bone and soft tissue structures. Limits of the examination, superiorly the upper border of T12, inferiorly the first sacral segment, posteriorly the skin surface, anteriorly the aorta. All the vertebra should be projected in lateral profile with visualisation of the joint spaces.   Lumbar Spine Rt Lateral Radiograph Related Projections Lumbar spine AP Lumbar spine obliques. Lumbar spine L5/S1 junction. Additional modalities CT MRI